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I certify that I am the parent or legal guardian for my child(ren). I hereby give my permission for any supervisor, coach or other team administrator associated with the Arbuckle Xtreme Cheer, LLC to seek and give appropriate medical attention for our child(ren) in the event of an accident, injury, illness. I will be responsible for any and all costs associated with any necessary medical attention and/or treatment.

I hereby waive, release and forever discharge Arbuckle Xtreme Cheer, LLC from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in Arbuckle Xtreme Cheer, LLC activities, whether or not damages or loss is due to negligence. I hereby acknowledge that my children is (are) physically fit and capable of participation in all activities.

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I fully understand that Arbuckle Xtreme Cheer staff members are not physicians or medical practitioners of any kind. With that in mind, I hereby release the Arbuckle Xtreme Cheer staff to render first aid to my child/ward in the event of any injury or illness, and if deemed necessary by the staff, to have authority, at my expense, in the event I cannot be reached, to seek medical help, including transportation whether paid or volunteer, to any health care facility or hospital, and if necessary, I authorize medical treatment. I verify that my child/ward has passed a medical examination within the last twelve months and is capable of participating in the activities of fitness classes, cheerleading, dance and tumbling.

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Cheerleading and fitness classes are reasonably safe as long as certain guidelines are

followed, but there is an inherent risk of injury as in any athletic activity. Cheerleading and fitness classes are an anaerobic/aerobic activity that includes, but is not limited to, jumping, stunting, motions, and tumbling. Arbuckle Xtreme Cheer, LLC recommends each athlete undergo a physical examination by his/her physician before beginning cheerleading and/or fitness activities. Each student must inform their coach of all injuries and/or chronic conditions. Although the probability of injury is minimized if you practice correctly, there is always the possibility of one occurring. It is important that each athlete listen to the trained coaching staff -- doing so greatly lessens the risk of injury.

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By registering my child(ren) with the Arbuckle Xtreme Cheer, LLC I agree to participate (or allow my child(ren) and family members to participate) in the Arbuckle Xtreme Cheer, LLC and hereby release Arbuckle Xtreme Cheer, LLC its directors, officers, agents, coaches, and employees from liability for any injury that might occur to myself (or to my child(ren) and family members) while participating in the Arbuckle Xtreme Cheer, LLC program, including travel to and from training sessions or other scheduled team activities.

I agree to indemnify and hold harmless the above mentioned organizations and/or individuals, their agents and/or employees, against any and all liability for personal injury, including injuries resulting in death to me, my child(ren) and/or other family members, or damage to my property, the property to my child(ren) and/or other family members, or both, while I (or my child(ren) or family members) participating in the Arbuckle Xtreme Cheer, LLC program and other classes

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This must be filled out in order for your child’s name and/or picture to appear on our website, or

any public forum for the use of advertisement and marketing. In the course of updating and maintaining the Arbuckle

Xtreme Cheer website and social media sites, we would like to be able to include photos/images of cheerleaders at various events and activities. All pictures will be in good taste. Please fill in the information below to allow us to use videos/images and first and last names of your child. As a parent or guardian of an athlete at Arbuckle Xtreme Cheer, LLC, I have read the above information about the publication of photos/images and names on its website and social media sites and I understand this agreement will be kept on file at the gym. I give permission for Arbuckle Xtreme Cheer, LLC and anyone affiliated with the program to use my child's name and picture on their website and social media sites. This permission is granted with the understanding that policy as outlined above is to be followed.